My day started out awful and just continued to get worse. Let me give you a little history about myself. I've been nursing since 6/01. I did a six-week stint on the med-surg floor and then took a full-time position on the psychiatric unit. I love the psychiatric unit. We have lots of time to spend with the patients, talking and nursing. Of course, there are hectic days. But not like the medical floor. Before long, they put me on nights. I couldn't take it. Felt like I was divorced from my family and had visiting privileges. My daughter (6) was suffering without her mother around so I found a day job at another hospital 100 miles (round trip) away and was willing to make the commute for a day job. A week after I turned in my resignation, my nurse manager calls me, states she found a day job for me in the hospital--primary psych / float. Which meant, when they didn't need me on psych, I would float to the med-surg floor. Yesterday was one of those float days. It was terrible. Before I got out of report, the surgeon had visited a patient who had been admitted at 0330 and decided to do an appendectomy on him. He wanted the patient in the OR stat. Well, the patient was Hispanic and spoke not one bit of English and I had to do a preoperative checklist. Before I could round up someone who spoke his language, the OR girls where there to pick him up. They seemed bothered that this patient wasn't ready. Luckily, one of the night shift nurses who was on her way out the door, spoke Spanish fluently and I was able to complete the preoperative checklist and get the man to surgery. Then, I went to do my a.m. rounds. The next patient I went to see was another man due in surgery shortly. I figured I'd go ahead and have his preoperative checklist complete when the OR girls got there. Well, the patient wasn't in his room. Now mind you, I don't work this floor and didn't know anything about any of the patients. The unit secretary stated he liked to walk the floors. I'm walking all over the unit trying to find this fellow with no luck. Finally, I let the charge nurse and nursing supervisor know. They called out a search for the patient. I continued on. One of my first patients was told by the doctor that had already been around that he could be discharged after his 0900 meds. Of course, the patient thought he'd be walking out the door at 0910, but that didn't happen. We finally managed to get the fellow out the door around 1100. Another patient I had was a DNR with CHF. He was suffering so much. He was scared and so short of breath. Nothing was seeming to help him. He had no family members and his anxiety level was building by the minute. Mine was too. About this time, my first patient from surgery returned--the Hispanic. He was smiling and kind and through some broken-Spanish on my part and some broken English on his part, stated he was in a little pain--no pain meds needed. But still, the vital signs had to be done q 15 minutes. Two nurses aides for 25 patients! Couldn't ask one of them. They were working hard as they could washing, feeding, etc. all the patients. By now, my CHF patient was panicking. He was trying to get out of the bed. I'm running back and forth from the nurses' station to the patient's bedside, calling the doctor for orders. Finally get an order to send the patient to the ICU and the nursing supervisor tells me that he is a DNR and she just doesn't have a bed for him in ICU. Along about this time, the OR girls show up to get my second patient (remember the one who went AWOL). He had walked back to his rest home and they brought him back to the hospital. Because he had drunk some coffee, OR said they'd do him last in the afternoon. Instead, they show up at 1030! And of course, the preoperative checklist had to be done. By now, several depts are involved with my CHF patient, respiratory, lab, the anesthesiologist (none of us could get an IV started). The doctor was insisting that one of his patients in the ICU could come to the floor and this patient could take her place. So we got housekeeping involved. By now, I had finally gotten an order for some Morphine (thank God for Morphine) and this helped with the man's anxiety (and mine). We finally had a room for him in ICU and I pushed his bed over to the ICU and transferred him. By this time, my second surgery was arriving but because he was such a problem, the supervisor wanted to put him near the nurses' station so his room was changed (thank God for small miracles). I had to help the supervisor clean out the room she wanted him in and transfer the patient in there to the skilled nursing unit. A task in itself. I was worn out. It was close to 1400 and I still had not managed to have breakfast or lunch. I finally manage to make it downstairs to the cafeteria at 1410 and they stop serving at 1330 and refuse to save any plates, stating they have to have the stuff put up by 1330. I'm frustrated, tired, hungry. By this time, I just feel like walking out and having a good cry. One of the girls in the cafeteria opens the refrigerator and states she can give me some watermelon. I take it and devour it. I go smoke a cigarette. When I get back to the unit, I learn that I'm getting 3 patients. A 14-day old dehydrated Hispanic infant (with mother who speaks no English), an 80 year old confused demented patient that is hard to redirect, and a 1-mo old infant who the doctor is going to do emergency surgery on him. I get the 14 day old infant first. The hospital has access to a language line so I took a laptop in the patient's room and spent an hour going from the interpreter to the mother to me to get the admission questions answered. But it was done. I managed to put in a care plan and an admission note, too. Then, my surgery baby shows up. Don't have time to do the admission questions, I just try to get the preoperative checklist done for the OR people. About that time, the surgeon and the anesthesiologist walk in the room and take over the conversation. My questions have to wait. Once they leave, I attack the parents with more questions. Then, I'm paged overhead. My 80 year old has shown up and I'm needed in her room. I had to use the nurses' button in the patient's room and admit that I just couldn't leave this baby at this time. That the surgeon was READY for her and I had to do the paperwork. So, another nurse walked down to that room and assisted that woman. Well, that woman's mind is GONE. You can not redirect her, she was walking all over the unit, going into other patient's rooms. I literally had to hold her hand and let her walk with me. I tried to start an IV on her which was a dangerous thing. I finally called for the charge nurse to call the doctor for some Haldol and some benzo to calm her down. Which I got, but I had to run all the way to the Pixus in the ER to get the injectable Valium. I run into the supervisor who admits we should have never let that 80 year old be admitted to the med-surg floor. She definitely is a psych case. I had to baby-sit this lady. I actually sat on her bed and hand-fed her her supper, and then brought a computer in her room and tried to do some of my work. No such luck. The woman just wouldn't calm down. So, I literally picked the woman up like a baby (I'm pretty big and she didn't weigh a whole heck of a lot) and tucked her in her bed, shut the lights off and FINALLY, she fell asleep. By this time, the charge nurse was calling me asking if I could give her report for the night shift. I stated I could if someone would come and sit with this lady. She sent someone and I managed to give report, finish my paperwork and walk around like a zombie for a few minutes. The night shift girls felt so sorry for me. I still had two care plans to do and two admissions paperwork. The night shift girls stated that since they'd have to call the nursing home for most of the info on the 80 year old lady, that they'd do it later and for me to go home and get some rest. Everyone agreed that it had been a horrible day for me. They all encouraged me to come back and work with them again, and under my arrangements to work during the day at that hospital, I'll have to. But when I got home last night, all I could do was say how much I hate my job and how I hate nursing and the next time I have a day like today, I just going to walk out and say the "heck with it all" and throw my nursing license at them and walk out. Now, I wonder, would I really do that . . .